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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL NTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT /20rnt - -,Qo v e,-(o PHONE NC(Zcf q,3 -� �y <br /> ADDRESS <br /> AGENCY NAME &v 0 ;Cul r4udr� Servic e} PHONE NO(zc�k) <br /> ADDRESS 1103 W.. v►e, S iriz_ CR' 25 30'7 <br /> FILE ADDE05 LEAD AGENCY DUATB <br /> 5tV,arb Nu:;er!,4-10''34 NtcrlaafZcf�irtit�t,hLan•� SS Pl i���tr7 <br /> Mcci mdl!rn dlf:4 ' ):SD g&±b l4yJ fi1°ud)LGtrg ` <br /> i C'"1'3' S• v14+t 6 <br /> Mae <br /> o n r s - 10;300 4vlanRECE <br /> 1 re►tih[av►p <br /> 'LS�s" U7iguw�, �nue� S�vcl�h� . <br /> ,51n(.kfml A P 9 1 <br /> _S fr1C1uU+�1 rreS� 3+3�! CLth(C tri ve _`S10C SAN .JOAO"a ink�;{�! ^`M•, :, <br /> �j�in..'fL,ngj eArd/ _ -11ab'TeerPe ®f�.s FUBLiC:Nc•+� <br /> 14ir}a Mtes'ier- �7 3� 'T2tvNt I�--. S-i-vGi� JIROP. is " ;�. <br /> R,•rrcon•�t7 - 3300 �ucl�rloc 2zt. St�c�.--iu� <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION(EHD)POLICY#92-007,ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION AND A NON-REFUNDABLE DEPOSIT OF$78.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WMUN THE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> 5. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATUR.EOF APPLICANT A—liV7 YneVl, —PaV- . DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 12/92) <br />